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Biomedical subjects

J Kollath

Publications and source records attributed to J Kollath.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Salvage of balloon expanded vascular endoprostheses (stents)].

Since 1987 patients have been treated with tantalum stents at our hospital (iliac arteries n:40, femoro/popliteal arterie n:35). Before expanding indication for stent implantation to other more difficult areas and vessel segments, we need to guarantee that a misplaced or not sufficient expanded or only temporary used stent, perhaps after dissections, could be rescued out of the vessel without damage of the vessel wall. Therefore we used cadaveric arteries and a special "retrivel set" To rescue the expanded stent through the introducer sheet without wessel wall damage was possible in all cases (iliac arteries n:5, femoral arteries n:5). In a second attempt, we showed, that even a TEA was possible, using a ringstripper which cut a typical cylinder of the atheriosclerotic vessel wall overpassing and including the stent. In 7 out of ten cases (cadaveric iliac arteries) the retrograde ringstripping-procedure was successful. The other 3 cases required an incision of the vessel with local thrombendarteriectomia. Insofar a stent implantation should not be considered as a contraindication for this surgica treatment else in later history.

Angioplasty, Balloon↗
PubMed1991

Effect of aortic sclerosis on bone mineral measurements by dual-photon absorptiometry.

Measurements of the bone mineral content (BMC) of lumbar spine by dual-photon absorptiometry (DPA) are performed mainly in the anteroposterior (AP) projection. Due to superimposition of the abdominal aorta, the BMC measured for patients with aortic calcification usually is too high. To determine the influence of aortic calcifications, DPA scans were performed in the AP-projection on 100 dissected abdominal aortae with different degrees of atherosclerosis placed on a human lumbar spine cast in lucite. The measured values were compared with those obtained in the same projection without the aortae. The average increase of the BMC values relative to the mean for the vertebrae L2 to L4 for aortae with severe complicated lesions, i.e., those containing larger amounts of calcium, was 0.03 g/cm2, with a maximum deviation of 0.09 g/cm2. Aortae with fatty streaks or fibrous plaques did not cause significant increases of the BMC. The mean deviation for aortae with mild complicated lesions, i.e., those containing smaller amounts of calcium, was within the range of instrument precision.

Absorptiometry, Photon↗
PubMed1990

[Changes in the lungs and pleura following chemoembolization of liver tumors with mitomycin-lipiodol].

The authors performed 68 liver embolizations in 51 patients. As selectively as possible, Lipiodol, to block the capillary bed, and a chemotherapeutic agent were injected into the liver tumors. A CT performed 24 hours after treatment showed the distribution of the contrast medium which is also an indicator of the distribution of the chemotherapeutic agents. It was found that the contrast medium had accumulated not only in the liver but also in the lungs. Here, four different degrees of accumulation were found, according to the amount of Lipiodol used. Embolization of the liver thus involves potential hazards for the lungs, such as microembolisms, pneumonia, and toxic effects of the chemotherapeutic agents.

Adult↗
PubMed1990

[Chemoembolization of primary liver cancer].

At the University of Frankfurt/M. we perform chemoembolization of the liver in patients with inoperable liver cell carcinoma. Before application of embolization material vasoconstriction of healthy blood vessels is achieved by intraarterial injection of norepinephrine. This procedure improves selectivity of tumor embolization. Methods, indications, contraindications and results are presented.

Carcinoma, Hepatocellular↗
PubMed1989

[Rotational angioplasty--recanalization of chronic arterial occlusion using a slowly rotating catheter. Clinical results with 100 patients].

Between December 1986 and January 1989, 100 patients with chronic occlusions of peripheral arteries were treated with the new technique of low speed rotational angioplasty. This uses a relatively thick, flexible and blunt catheter, which is driven by an electric motor (100 to 200 r.p.m.). The success rate in the superficial femoral and popliteal arteries of the initial intervention for occlusions less than 10 cm was 90%, for occlusions of less than 10 cm, it was 80%. Occlusions on which conventional techniques had failed were successfully recanalized in 65%. Recanalisation was also successful in seven out of 12 patients with occluded iliac arteries. There were no perforations or other serious complications. It is concluded that the new method is particularly effective and safe for recanalisation of chronic vascular occlusions and should also be considered for cases which previously could only be treated surgically.

Adult↗
PubMed1989

Low-speed rotational angioplasty in chronic peripheral artery occlusions: experience in 83 patients. Work in progress.

Between December 1986 and October 1988, 83 patients with chronic peripheral artery occlusions were treated with a new technique. In 56 patients, the superficial femoral artery was completely occluded; in 21 patients, the popliteal artery; and in six patients, the iliac artery. The length of occlusion ranged from 5 to 35 cm (mean, 12.5 cm). The duration, estimated by history, was 5-48 months (mean, 16.5 months). In seven patients, durations of 6-36 months were documented angiographically. A flexible, blunt, motor-driven rotating catheter was introduced through an 8-F sheath, and rotational angioplasty was performed at low speed (up to 200 rpm). In 49 of 60 (82%) patients in whom this new technique was used as the primary intervention, the occlusions were successfully reopened. In 23 patients in whom conventional methods had failed more than 4 weeks earlier, the success rate for rotational angioplasty was 67% (12 of 18 patients); when the time interval was less than 4 weeks, only one of five patients was treated successfully. In none of the 83 patients did a perforation occur. This new technique can reopen chronic artery occlusions with a high degree of success and without the danger of vessel-wall perforation, even after failure of conventional techniques.

Adult↗
PubMed1989

[Rotation angioplasty--clinical experiences in 83 patients with chronic arterial vascular occlusion].

Chronic, total vascular occlusion represents the limit for use of balloon dilatation. Occlusions of the superficial femoral artery and popliteal artery of more than 10 cm in length have a low recanalization rate of 50 to 60% with conventional angioplasty. In iliac artery occlusions, in addition to a high rate of complications, the recanalization rate is only about 30 to 40%. Starting in 1984, we developed a slowly rotating (100 to 200 r.p.m.), electrically-driven, flexible catheter with a blunt tip, inside lumen and outer diameter of 2.2 mm for the purpose of recanalization (Figure 1). The theoretical basis was that such a catheter would seek the soft occluding thrombus as the path of least resistance. Since 1986, the procedure has been carried out in 56 patients with occlusion of the superficial femoral artery, 21 with occlusion of the popliteal artery and six with occlusion of the iliac artery. The duration of occlusion ranged between five and 48 months and the length of the occlusions between 5 and 35 cm (mean 12.5 cm); the patients were in Fontaine stage II and IV, the ankle arm-index ranged between 0 and 0.86 (mean 0,51). After antegrade or retrograde puncture of the common femoral artery and intra-arterial injection of 5,000 units of heparin, the rotation catheter was advanced through an 8F sheath through the occlusion by means of slow rotation (Figure 2). After contrast medium injection to document the intraluminal position of the catheter and the catheter exchange over a 0.35'' wire, the channel created was dilated.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Nephrotoxicity of high and low osmolar contrast media: case control studies following digital subtraction angiography in potential risk patients.

The urinary excretion of kidney-specific marker proteins before and 120 hours after intravenous injection of either high- or low-osmolar contrast media (CM; diatrizoate, iopamidol 370) was monitored in patients after digital vascular imaging. Inclusion criteria for the randomized clinical study in a total of 40 patients (15 women, 25 men; mean age, 64.5 years) were at least 50 years of age or diabetes mellitus with normal creatinine concentration in serum. Compared with the control period, the elimination of tubular indicator enzymes alanine aminopeptidase, gamma-glutamyltranspeptidase, alkaline phosphatase, as well as of glomerular localized angiotensinase A was significantly higher in all patients after injection of the CM. The most significant differences were observed after 48 hours. In contrast, lysosomal N-acetyl-beta-D-glucosaminidase activity in urine specimens reacted less clearly and appears to be a less sensitive parameter in assessing CM nephrotoxicity. Elimination of brush border as well as of glomerular marker proteins was significantly lower after intravenous injection of low-osmolar CM iopamidol 370 (832 mOsm/kg) than after meglumine diatrizoate 76 (2100 mOsm/kg). In all 40 patients a significant decrease in creatinine clearance was observed; however, patients receiving diatrizoate had a significant decrease in creatinine clearance (period 0 versus 24 to 48 hours after CM), whereas patients after administration of iopamidol had not. No difference was found between creatinine clearance after 48 hours of CM injection within both groups of CM. Due to noninvasive parameters of kidney damage nonionic, low-osmolar CM are less nephrotoxic in potential risk patients, and should be preferred to conventional CM.

Aged↗
PubMed1989

[Conventional roentgen diagnosis in traumatology].

The efficacy and efficiency of 5874 diagnostic X-rays at the Department of Traumatology, University Clinics of Frankfurt, West-Germany, were reviewed. Efficiency of the method was extremely high with false results in only 0.00017%. The efficacy of the diagnostic traumatologic X-ray procedures could be markedly increased with a more critical approach in indications and the avoidance of routine diagnostic X-rays mainly of the skull. This study shows an optional reduction of traumatologic X-rays of 16% and a concomitant reduction in costs of 17.2%.

Adult↗
PubMed1988

Results of low speed rotational angioplasty for chronic peripheral occlusions.

After experimental investigation using postmortem human arteries, 19 patients with chronic peripheral artery occlusions were treated with a new angioplasty technique between December 1986 and October 1987. In 17 patients the superficial femoral artery and in 2 patients the popliteal artery were completely occluded. The length of the occlusions ranged between 5 and 25 cm (mean 11). The duration--estimated according to patients' history--was 5 to 48 months (mean 17). In 5 patients, durations of up to 30 months had been documented by angiography. A flexible, blunt, motor-driven rotating catheter was introduced through an 8 or 9Fr sheath and rotational angioplasty was performed at low speeds (up to 200 rpm). In 11 of 14 patients in whom this new technique was used as the primary intervention, the occlusions could be successfully reopened. In 2 patients after failure of conventional techniques the rotating catheter could not bypass the preexisting dissections in the same intervention. In 2 of 3 further patients after failure of conventional techniques the occlusions could be successfully reopened in a second intervention after several weeks. In none of the 19 patients did a perforation occur. It is concluded that with the new technique chronic peripheral artery occlusions can be reopened with a high success rate and without the danger of arterial wall perforation. The method can also be used in patients in whom conventional techniques have failed.

Adult↗
PubMed1988

Non-operative revascularisation of renal artery occlusion by transluminal angioplasty.

A modified transluminal angioplasty technique for treatment of renal artery occlusion has been developed. From 1980 to 1985, 16 consecutive patients with 17 complete main renal artery occlusions underwent interventional transfemoral angiography for the purpose of recanalisation. In 12 patients the orifice of the renal artery could be clearly localised, so an attempt was made. Successful revascularisation of the occluded vessel was accomplished in seven patients. In four of these seven, contralateral renal artery stenosis was detected and dilated at the same session. Intact vasculature could be demonstrated distal to the occlusion. In six patients an improvement of renal function was apparent at the end of the dilatation procedure; this was indicated by the appearance of contrast material in the pelvicalyceal system. The mean serum creatinine fell from 4.6 +/- 2.9 to 1.9 +/- 0.4 mg/dl. Radioisotope studies confirmed improvement of renal function in the previously occluded kidney in four of four patients. Three patients had acute oliguric renal failure, which was reversible in two cases following revascularisation. Transluminal angioplasty improved hypertension in all cases. Mean blood pressure fell from 187/110 to 155/88 mmHg. Non-operative renal artery revascularisation can be achieved by transluminal angioplasty techniques and is an alternative to surgery in patients with increased operative risk.

Adolescent↗
PubMed1988

[Rotation angioplasty--initial clinical results of peripheral vascular occlusions].

After experimental investigations in postmortem human arteries, 19 patients with chronic peripheral artery occlusions were treated with a new technique between December 1986 and October 1987. In 17 patients the superficial femoral artery, and in two patients the popliteal artery, was completely occluded. The length of occlusions were between 5 and 25 cm (mean 10.9 cm); the duration (estimated according to patient's history) was 5-48 months (mean 17.2 months). In five patients, durations of up to 30 months had been documented by angiography. A flexible, blunt, motor-driven rotating catheter was introduced over an 8 or 9 F sheet and rotational angioplasty was performed at low speed, up to 200 rpm. In 11/14 patients in whom this new technique was used as the first attempt, the occlusions could be successfully reopened. In two patients after failure of the conventional technique the rotating catheter could not bypass the preexisting dissections in the same intervention. In 2/3 further patients after failure of the conventional technique the occlusions could be successfully reopened in a second intervention after several weeks. In none of our 19 patients did a perforation occur. It is concluded that by using the new technique, chronic peripheral artery occlusions can be reopened with a high success rate and without the danger of vessel wall perforation. The method can also be applied in patients in whom conventional techniques have failed.

Adult↗
PubMed1987

[Rotation angioplasty--a new procedure for reopening and dilating blood vessels. Experimental findings].

16 fresh postmortem specimens of human femoral and popliteal arteries with severe atherosclerosis were removed and angiography was performed. Eight vessels were completely occluded and eight showed stenoses of up to 60%. All occluded vessels were heavily calcified. The duration of occlusion, estimated according to the patient's history, ranged from 1 to 2 years. In one case, a duration of 18 months was documented by angiography. The lengths of the occlusions were between 5 and 12 cm. A rotating catheter was introduced through a 9F guiding catheter. All stenosed vessels were passed and seven out of eight occluded vessels, in which passage was not possible using conventional wires, were successfully reopened at low speed rotation of 200 rpm. Angiography, as well as histology, showed no perforation, and angioscopy revealed a smooth surface of the new channel. In three vessels this new channel was dilated with a balloon catheter and in one with an elastic element under rotation. It is concluded that with the new technique it is possible to reopen totally occluded human arteries which cannot be passed by conventional methods.

Angioplasty, Balloon↗
PubMed1987

[Digital subtraction phlebography of the veins of the arm and the superior vena cava].

We report on the results of 40 digital subtraction phlebograms of the great veins of the upper extremities and the mediastinum in 32 patients. In all cases diagnostic satisfactory examinations were achieved that demonstrated the anatomy of the veins in question. The method can be either used for the primary diagnosis or for controls during lysis of thrombotic lesions. The v. cava superior could be opacified even after ipsilateral injection of diluted contrast media in one-sided thrombotic occlusions of these veins.

Axillary Vein↗